While these reviews might be helpful, they are not a substitute for the expertise, skill, knowledge and judgement of healthcare practitioners in patient care. However, I was extremely groggy the next morning and ended up back in bed by shortly after lunch, sleeping for almost 2 hours. Once the PTSD reared its ugly head again, Prazosin was added. However, the insomnia went on a rampage so, Doxipen was added, first at 50 mg for a week (didn't help much) so, the doc increase to 75mg. I'm going to stay with what was prescribed for this coming week & hope for the best although so far, hope isn't helping.""Silenor's active ingredient is doxepin.I tried it two more times, taking it earlier each time, but the effect was the same: it takes too long to work and leaves me groggy and unable to function the next day. A 90 day supply of doxepin (it will be in liquid form to be mixed with water) costs .I will not be taking it any more.""For the PTSD, Insomnia, anxiety & depression, I take Lunesta 3 mg, Prazosin 2mg (for the PTSD dreams), Doxepin 75mg, & have Xanax for the anxiety. I gave this information to my doctor and he prescribed the doxepin.My insurance company is not involved and this has saved me a substantial amount of money.
Doxepin is used primarily to treat depression and to treat the combination of symptoms of anxiety and depression.
Avoid; strong anticholinergic and sedative effects; may cause orthostatic hypotension (Beers criteria) Consider alternatives; if must use, initiate with lower initial dose May cause confusion and oversedation in elderly Sedation, fatigue, weakness, lethargy Dry mouth Constipation Blurred vision Headache Agitation Insomnia Anxiety Nausea, vomiting Sweating Confusion, extrapyramidal symptoms (EPS), dizziness, paresthesia Orthostatic hypotension, ECG changes, tachycardia Increased LFTs Tinnitus Sexual dysfunction Rash Seizure Agranulocytosis Thrombocytopenia Eosinophilia Leukopenia SIADH 65 years In children and young adults, risks must be weighed against the benefits of taking antidepressants Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies; this should be done during initial 1-2 months of therapy and dosage adjustments The patient’s family should communicate any abrupt changes in behavior to the healthcare provider Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy This drug is not approved for use in pediatric patients Use caution in BPH, urinary retention, decreased GI motility, hyperthyroidism, seizure disorder, brain tumor, diabetes, hepatic impairment, cardiovascular disease, mania/hypomania, respiratory disease, and seizure disorders Clinical worsening and suicidal ideation may occur despite medication in adolescents and young adults (aged 18-24 years) Risk of anticholinergic side effects Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy CNS depressant; can impair alertness and motor coordination; avoid use with other CNS depressants (eg, alcohol) Overdose may cause EKG QRS widening and risk of dysrhythmias Protect capsules and oral concentrate from direct sunlight Prescriptions should be written for smallest quantity consistent with good patient care; patient's family or caregiver should alert healthcare professional about emergence of suicidality and related behaviors including agitation, panic attacks, irritability, impulsivity, mania, and insomnia or if worsening depression or psychosis occurs Anticholinergic effects including blurred vision, urinary retention, xerostomia, and constipation may occur Neuropsychiatric symptoms may occur unpredictably including anxiety and psychosis Bone fracture reported with use of antidepressant therapy; consider possibility of fracture if patient presents with unexplained bone pain, joint tenderness, bruising or swelling May cause orthostatic hypotension; use caution in patients at risk of this effect or that may not tolerate hypotensive episodes (eg, hypovolemia, cardiovascular or cerebrovascular disease and others) Sleep related activities including sleep driving, eating food, cooking, making phone calls reported; discontinue therapy if patient reports sleep-related episodes Possibility of EPS and neuroleptic malignant syndrome (NMS) May cause confusion in the elderly; avoid doses Exact mechanism for doxepin's sleep maintenance effect is unknown; however, doxepin's action is believed to result from antagonism of the histamine H1 receptor Mechanism of action for depression is unknown; may increase CNS synaptic concentrations of serotonin and norepinephrine by inhibiting reuptake The above information is provided for general informational and educational purposes only.
Individual plans may vary and formulary information changes.
Like most antidepressants, doxepin has also been used to treat panic disorder , obsessive-compulsive disorder , attention-deficit/hyperactivity disorder , enuresis (bed-wetting), eating disorders such as bulimia nervosa , cocaine dependency, and the depressive phase of bipolar (manic-depressive) disorder.
It has also been used to support smoking cessation programs.